Organization
EC OPCO MEDINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY W. FLEMING (CONTROLLER)
(971) 337-3922
Entity
Organization
Contact information
Practice address
1046 N JEFFERSON ST, MEDINA, OH 44256-1102
(330) 721-2000
Mailing address
5885 MEADOWS RD STE 500, LAKE OSWEGO, OR 97035-8646
(971) 254-1368
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902125198
—
OH
Enumeration date
02/02/2018
Last updated
03/12/2019
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